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L. Wang, D. D. Koch; Improvement in Optical Image Quality by Custom Selection of Aspherical Iol. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2425. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
In a previous study, we found that the amount of IOL spherical aberration (SA) producing best image quality varied widely among subjects and could be predicted based on the full spectrum of anterior corneal higher-order aberrations. The purpose of this study is to evaluate the improvement in optical image quality by custom selection of an aspherical IOL.
In 65 eyes of 43 patients with ages 40 to 80 years, simulated implantation of 5 IOLs in each eye was performed: 1) customized aspherical IOL with the optimized IOL SA predicted using the formulas developed in previous study (Optimized IOL), 2) Tecnis IOL (SA = -0.27 µm), 3) AcrySof IQ (SA = -0.20 µm), 4) SofPort AO (SA = 0.00 µm), and 5) traditional spherical IOL (SA=+0.18 µm). Simulations were performed for perfect IOL centration and horizontal decentration of 0.25 mm and 0.50 mm. Using the ZernikeTool program (AMO), the polychromatic modulation transfer function (PMTF) and the PMTF volumes up to 15 and 30 cycle/degree with Stiles-Crawford effect were calculated to assess the optical image quality (6- and 4-mm pupils). Repeated analysis of variance and Bonferroni correction were used.
For a 6-mm pupil, the Optimized IOL produced higher PMTF values with decentration up to 0.25 mm; with decentration of 0.50 mm, values with Optimized IOL, Tecnis and IQ were better than those with AO and standard IOL. For a 4-mm pupil, optical image qualities with the Optimized IOL, Tecnis and IQ were significantly better than those with AO and standard IOL with decentration up to 0.25 mm.
Our results demonstrated that, with 6-mm pupils, a customized aspherical IOL based on anterior cornea HOAs significantly improved optical image qualities with decentration up to 0.25 mm. The optimized IOL and IOLs with negative SA provided better optical quality than AO and standard IOLs with decentration up to 0.5 mm for 6-mm pupils and with decentration up to 0.25 mm for 4-mm pupils.
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